A patient with cheek cancer has a tumor of 2.5 cm located close to and involving the lower alveolus. A single mobile ipsilateral lymph node measuring 6 cm is palpable. The TNM stage is:-
High-Yield Explanation
Cheek cancer (2.5 cm) located close to and involving the lower alveolus (T4a); A single mobile ipsilateral lymph node measuring 6 cm is palpable (N2a); TNM stage is T4a N2a M0. 8TH AJCC TNM CLASSIFICATIONTx - Tumor cannot be assessedTis - Ca - in-situT1 - Tumor upto 2cm in size; up to 5mm depth of invasionT2 - Up to 2 cm in size with > 5 -10 mm depth of invasion - >2 - 4 cm, depth ofinvasion up to 10 mmT3 - Tumor up to > 4 cm in size and >10 mm depth of invasionT4a(lip)- Tumor invades through coical bone, inferior Alveolar nerve, floor of mouth,skin of chin or noseT4a(oral cavity)- Tumor invades the coical bone, mandible, maxillary sinus or skin of faceT4b - Tumor involves through masticator space, pterygoid plate Skull base and / orencases internal carotid aery Regional lymph nodeNx - Lymph node status cannot be assessedN1 - Metastasis to single ipsilateral LN up to 3 cm in greatest dimensionN2a - Metastasis to single ipsilateral LN up to > 3 -6 cm dimensionsN2b - Metastasis to multiple ipsilateral LN none >6 cm in greatest dimensionN3a - Metastasis to LN > 6 cm in greatest dimensionN3b - Metastasis to single or multiple LN with clinical Extra nodal extension MetastasisMx - Metastasis cannot be assessedM0 - No MetastasisM1 - Distant Metastasis